The importance of a thorough clinical examination in adolescent girls presenting with acute urinary retention

2021 ◽  
Vol 14 (2) ◽  
pp. e240378
Author(s):  
Oman Rai ◽  
Sanju Lama ◽  
Sanjay Wazir Pandita
Keyword(s):  
Urinary Retention ◽  
Adolescent Girls ◽  
Acute Urinary Retention ◽  
Lower Abdominal Pain ◽  
Paediatric Ward ◽  
Common Causes ◽  
History Of ◽  
The Common ◽  
Time Of Presentation ◽  
New Onset

We present an adolescent girl with a 1-day history of acute urinary retention and lower abdominal pain. She was admitted to the paediatric ward for ongoing treatment and investigations. Due to a myriad of factors including pain and anxiety, challenges posed included an incomplete initial abdominal and external genital examination. This case report highlights the importance of a focused history and performing an appropriate sensitive examination at the time of presentation. Furthermore, we explore the common causes of new onset urinary retention and unravel the case as it unfolds. We also highlight differential diagnoses (however, uncommon), which must be considered and not overlooked to avoid unnecessary investigations and to ensure timely management.

scholarly journals Imperforate hymen presenting with massive haematocolpos and acute urinary retention in a teenage girl: A case report

2012 ◽  
Vol 14 (4) ◽  
Author(s):  
Ipyana H. Mwampagatwa ◽  
Baraka A. Mponda
Keyword(s):  
Case Report ◽  
Urinary Retention ◽  
Adolescent Girls ◽  
Acute Urinary Retention ◽  
Clinical Presentation ◽  
Lower Abdominal Pain ◽  
External Genitalia ◽  
Imperforate Hymen ◽  
Lower Genital Tract ◽  
History Of

Imperforate hymen is relatively rare but it is the most frequently encountered obstructive anomaly of the female lower genital tract. The clinical presentation vary significantly from patient to patient depending on the age at diagnosis but in most cases the diagnosis is missed in early childhood and therefore the diagnosis is made after puberty when the patient present with haematocolpos, heamatometra or both. When this happens, the presentation could even be tricky because the patient may presents with unlikely symptoms apart from cryptomenorhoea like, urinary retention or bowel obstruction or both. Here we present a 16 years old girl with imperforate hymen and presented with history of lower abdominal pain and distension associated with acute urinary retention. She was treated by hymenotomy and improved dramatically and was discharge 6th day post operatively.  This case report is presented to address to clinicians the possibility of imperforate hymen with haematocolpos as a differential diagnosis in adolescent girls particularly those who have not started having their menses in their teens and present with acute urinary retention so that their external genitalia are carefully examined to exclude the possibility of imperforate hymen as a cause of acute urinary retention due to the haematocolpos.

scholarly journals Virginity-sparing management of hematocolpos with imperforate hymen: case report and literature review

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984676
Author(s):  
Thomas Obinchemti Egbe ◽  
Fidelia Mbi Kobenge ◽  
Emmanuella Manka’a Wankie
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Lower Abdominal Pain ◽  
Pelvic Mass ◽  
Urogenital Sinus ◽  
Primary Amenorrhea ◽  
Abdominal Ultrasonography ◽  
Imperforate Hymen ◽  
History Of ◽  
Good Treatment Option

Imperforate hymen results from failure of the endoderm of the urogenital sinus to completely canalize and has an incidence of 0.01% to 0.05%. This sometimes presents as a pelvic mass that compresses the bladder causing acute urinary retention. A 13-year-old girl was referred to our department with a history of primary amenorrhea, cyclic lower abdominal pain, abdominal–pelvic mass, constipation and acute urinary retention. She had an ultrasonography misdiagnosis of a huge ovarian mass before referral to our unit. On examination, the vagina was bulging and compressing the rectum. Repeat abdominal ultrasonography confirmed the diagnosis of hematometrocolpos. She underwent X-shaped hymenotomy with a favorable outcome. Diagnosis of imperforate hymen requires high suspicion index. Virginity-sparing surgery constitutes a good treatment option for cultural and religious reasons.

Natural history of benign prostatic hypertrophy and acute urinary retention

Urology ◽  
1976 ◽  
Vol 7 (1) ◽  
pp. 48-52 ◽  
Author(s):  
John D. Birkhoff ◽  
A. Roger Wiederhorn ◽  
Mary L. Hamilton ◽  
Hans H. Zinsser
Keyword(s):  
Natural History ◽  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Benign Prostatic Hypertrophy ◽  
Prostatic Hypertrophy ◽  
History Of

scholarly journals A high proportion of novel ACAN mutations and their prevalence in a large cohort of Chinese short stature children

2021 ◽  
Author(s):  
Li Lin ◽  
Mengting Li ◽  
Jingsi Luo ◽  
Pin Li ◽  
Shasha Zhou ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Family History ◽  
Short Stature ◽  
Bone Age ◽  
Hormone Treatment ◽  
Pathogenic Variants ◽  
Common Causes ◽  
History Of ◽  
The Common ◽  
Next Generation Sequencing Ngs

Abstract Context Aggrecan, encoded by ACAN gene, is the main proteoglycan component in the extracellular cartilage matrix. Heterozygous mutations in ACAN have been reported to cause idiopathic short stature. However, the prevalence of ACAN pathogenic variants in Chinese short stature patients and clinical phenotypes remain to be evaluated. Objective We sought to determine the prevalence of ACAN pathogenic variants among Chinese short stature children and characterize the phenotypic spectrum and their responses to growth hormone (GH) therapies. Patients and Methods Over 1000 unrelated short stature patients ascertained across China were genetically evaluated by Next-generation sequencing (NGS)-based test. Result We identified 10 novel likely pathogenic variants and 2 recurrent pathogenic variants in this cohort. None of ACAN mutation carriers exhibited significant dysmorphic features or skeletal abnormities. The prevalence of ACAN defect is estimated to be 1.2% in the whole cohort, it increased to 14.3% among those with advanced bone age and to 35.7% among those with both advanced bone age and family history of short stature. Nonetheless, five out of eleven ACAN mutation carries had no advanced bone age. Two individuals received growth hormone therapy with variable levels of height SDS improvement. Conclusion Our data suggested that ACAN mutation is one of the common causes of Chinese pediatric short stature. Although it has a higher detection rate among short stature patients with advanced bone age and family history, part of affected probands presented with delayed bone age in Chinese short stature population. The growth hormone treatment was moderately effective for both individuals.

Aphthous Vulvar Ulcers in Adolescent Girls: Case Report and Review of the Literature

2010 ◽  
Vol 14 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Kimberly Lai ◽  
Emily Lambert ◽  
Mary Gail Mercurio
Keyword(s):  
Adolescent Girls ◽  
Sexual Transmission ◽  
Rare Condition ◽  
Unknown Etiology ◽  
Review Of The Literature ◽  
Aphthous Ulcers ◽  
Common Causes ◽  
History Of ◽  
Systemic Symptoms ◽  
False Accusations

Background: Aphthous vulvar ulcers are painful ulcerations on the genital mucosa frequently accompanied by systemic symptoms. They are most commonly reported in young women and adolescents without a history of sexual contact. Diagnosis is made by exclusion of more common causes, and treatment for this self-limited condition is mainly symptomatic. Objective: Clinicians should be aware of this rare condition to avoid misdiagnoses and unwarranted investigations into sexual abuse or false accusations of sexual activity. Methods: We report a case of an 11-year-old girl with systemic symptoms and vulvar ulcers of unknown etiology. Results: The patient's illness was consistent with previous reports that vulvar ulcers can occur without sexual transmission or a documented infectious cause. Conclusion: A lack of general knowledge regarding this entity may lead to its exclusion from the differential diagnosis of vulvar ulcers in this patient population. Aphthous ulcers should be strongly considered in any adolescent with vulvar ulcers.

scholarly journals Haemoptysis in a toddler: An uncommon presentation of unusual foreign body ingestion

2020 ◽  
pp. 102490792094405
Author(s):  
Sadesvaran Muniandy ◽  
Mohd Faiz Mohd Shukri ◽  
Nur Izzah Ghazali ◽  
Mohd Saiful Adli Ishak ◽  
Irfan Mohamad ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Body Ingestion ◽  
Case Presentation ◽  
Unusual Foreign Body ◽  
Uncommon Presentation ◽  
Common Causes ◽  
History Of ◽  
The Common ◽  
Tract Infections ◽  
High Index Of Suspicion

Introduction: Haemoptysis is uncommon in toddler. Lower respiratory tract infections and foreign body are among the common causes. Case Presentation: We are reporting a case of a child presented to emergency department with complaint of mild haemoptysis, whom was later found to have a piece of broken satay skewer at the tonsillar region. The foreign body was removed during the procedure without any complication. Discussion: Foreign body ingestion, particularly a piece of broken satay skewer, is difficult to suspect without a proper history and eyewitness. Therefore, parent’s supervision is important. Emergency residents should have a high index of suspicion of foreign body ingestion in a child with vague symptoms. Conclusion: Foreign body is among the commonest cause of haemoptysis in an afebrile toddler. Acute haemoptysis in otherwise healthy toddler should alert the emergency residents about foreign body ingestion. History of food intake should be more thorough even if trivial.

Natural History of Prostatism: Risk Factors for Acute Urinary Retention

1997 ◽  
Vol 158 (2) ◽  
pp. 481-487 ◽  
Author(s):  
Steven J. Jacobsen ◽  
Debra J. Jacobson ◽  
Cynthia J. Girman ◽  
Rosebud O. Roberts ◽  
Thomas Rhodes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Natural History ◽  
Urinary Retention ◽  
Acute Urinary Retention ◽  
History Of

scholarly journals A rare cause of acute urinary retention in a young man: A median raphe penile cyst

2021 ◽  
Vol 16 (1) ◽  
pp. 114-116
Author(s):  
Mohd. Nazli Kamarulzaman ◽  
Azhani Chik ◽  
Hamid Ghazali
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Rare Complication ◽  
Sudden Onset ◽  
Glans Penis ◽  
Median Raphe ◽  
Case Presentation ◽  
History Of ◽  
Rare Lesion ◽  
Median Raphé

Background: A penile median raphe cyst is an uncommon congenital lesion that is formed due to failure of the median raphe to close completely during embryo development. The majority of the cysts are asymptomatic and often go unnoticed. Here, we report acute urinary retention as a very rare complication of a penile median raphe cyst. Case presentation: A 21-year-old single man presented with a sudden onset of acute urinary retention of one days’ duration. Urethral catheterization was done at the Emergency Department and this drained 800 ml of urine. On further questioning, he claimed that he had had a painless nodule at the glans penis since childhood. The swelling increased in size in the past week causing discomfort. He denied any history of genitalia trauma or recent sexual intercourse. On examination, there was a bluish lesion over the ventral aspect of the glans penis measuring about 3 x 2 cm. The lesion was later excised and histopathology revealed a median raphe cyst of the penis. Conclusion: A penile median raphe cyst is a rare lesion. Acute urinary retention caused by this lesion is very rare.

scholarly journals Spectrum of Ocular Trauma Presenting to ophthalmic OPD

2020 ◽  
Vol 5 (3) ◽  
Keyword(s):  
Vision Loss ◽  
Ocular Trauma ◽  
Risk Groups ◽  
Ocular Injury ◽  
Eye Injury ◽  
Central Hospital ◽  
Common Causes ◽  
History Of ◽  
Standardized Terminology ◽  
Time Of Presentation

Introduction: Ocular trauma is one of the most common causes of vision loss. Etiologies of ocular injury differ from area to area and from country to country, difference according to demographic or socioeconomic classes have been reported. Measures to be taken for prevention of ocular trauma require knowledge of the cause and mechanism of injury, which may enable more accurate planning to prevent such injuries. The classification of ocular trauma with standardized terminology was developed by Kuhn and associates. The International Society of Ocular Trauma subsequently used this terminology to develop a classification system for mechanical injuries of the eye. This study was conducted to identify the etiology and nature of ocular trauma affecting our population. Aim: To identify the causes of ocular trauma and determine the types of various injuries presenting to the ophthalmic OPD Al-Thawra central hospital Al-Baida Libya. Subjects and Methods: 80 patients included in this study Presented to ophthalmic OPD Al-Thawra central hospital AlBaida Libya with history of Trauma during a period of three months. Following data were collected: patient’s age, gender, affected eye, etiology of trauma, place of trauma, visual acuity and Ocular Injury to time of presentation. Result: There were 80 eyes of 80 patients, of which 77.50% were males and 22.50% were females. The ages ranged from 1–50 years. The highest incidence of trauma was seen in the 21– 30-year age group (30.0%). Blunt trauma occurred in 42.5% of cases and foreign body trauma in 33.3% of cases. The highest incidence of eye injury occurred at workplace (50.0%) followed by the Home (22.5%), then Playground (20.0%). Assault-related eye injury was seen in 25% of cases and 75% of all injuries were accidental. Conclusion: Education programs regarding the safety measures to be taken to protect the eyes during work and other activities will be quite helpful to minimize the incidence of ocular trauma among the risk groups.

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